Waterloo Catholics

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First sacrament registration for St. Ed's & BMAP school students

- Sacraments

- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Parish REQUIRED Please fill out this field. Please enter valid data.
- Parent information
- Parent/Adult #1
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Parent/Adult #2
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Phone Number Maximum 20 characters Please enter a phone number.
- Email Please enter an email address.
- Child Registration Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Is your child Baptized? REQUIRED Yes No Please fill out this field.
- Church where child was baptized: Please list parish, city Please enter valid data.
- Sacrament Program Fee50.0
Total:

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